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Home My WebLink About12-29-14 1 1505610143 � REV-1500 EX`°2_„> �. OFFICIAL USE ONLY PA Department of Revenue pennsylvania County Code Year File Number Bureau of Individual Taxes �P�TMEMOFREVENUE Po BOX.28o60� INHERITANCE TAX RETURN 21 13 1257 Harrisburg,PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 10 30 2013 11 27 1932 DecedenYs Last Name Suffix DecedenYs First Name MI KNIPE PATRICIA A (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW � 1. Original Return � 2. Supplemental Retum � 3. Remainder Return(Date of Death Priorto 12-13-82) � 4. Limited Estate � 4a.Future Interest Compromise � 5. Federai Estate Tax Return Required (date of death after 12-12-82) � g, Decedent Died 7estate � �� (At acheCo a�of�T�ust a Living Trust � S. Total Number of Safe Deposit Boxes (Altach Copy of Will) PY ) � 9. Litigation Proceeds Received � ��between 12 31�1 andit�Da95�f Death � 11.Election to tax under Sec.9113(A) , (Attach Schedule O) CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number BRUCE J WARSHAWSKY 717 238 6570 � REGISTF�OF WILLS l�ONLY � _� � p P�'1 First Line of Address '� � � �? �'�l � t") 2320 NORTH SECOND STREE ,,� � � N --P - _ r�� r?� r� Second Line of Address `� - ., .,., . ,., , , . r; r ,_::+ r-, r,..� 'T7 `r� `i <.DA�Cff FI1�ED � �� City or Post Office State ZIP Code A a � � rn HARRISBURG PA " , r c� v� � r � Correspondent's e-mail address: bjwC�cclawpc.com Under penalties of pe�jury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNAT RE OF PERSON RESPO IBLE FOR FILING TURN DAT � ` K ra M. Noll D SS 1015 Harriet St.. Carlisle PA 17013 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE • , Bruce J.Warshawsky L 2 2 � `"� ADDRES 2320 North Second Street, Harrisburg, PA Side 1 � 1505610143 15�5610143 J PDF created with pdfFactory Pro trial version www.pdffactorv.com PA Inheritance Tax Return Signature of Additional Fiduciaries ESTATE OF FILE NUMBER Knipe, Patricia A. 21-13-1257 Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. Signature#2 � � /(� � Name Kevin L.Knipe Address1 23 Stiles Drive Address2 City, State,Zip Marysville PA 17053 Date �S 1` PDF created with pdfFactory Pro trial version www.pdffactorv.com � 15�561U243 REV-1500 EX DecedenYs Social Security Number oe��ce�rSNeme: Knipe, Patricia A. RECAPITULATION 1. Real Estate(Schedule A)....................................................................................... 1. 2. Stocks and Bonds(Schedule B)............................................................................. 2. 1, 7 64 . 0 0 3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3. 4. Mortgages 8�Notes Receivable(Schedule D)........................................................ 4. 5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 42 . 91 6. Jointly Owned Property(Schedule F) ❑ Separate Billinq Requested............ 6. 7. Inter-Vivos Transfers&Miscellaneous�{nq Probate Property (Schedule G) U Separate Billing Requested............ 7. 8, Total Gross Assets(total Lines 1 through 7)........................................................ 8. 1,8 0 6. 91 9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 715 . �� 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 11. Total Deductions(total Lines 9 and 10)................................................................ ��. 715 . 0� 12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 1 , 0 91 . 91 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made(Schedule J)............................................... 13. 14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 1,0 91 . 91 TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers under Sec.9116 �5 O . �� (a)(1.2)X.00 16. Amount of Line 14 taxable 1,0 91 . 91 �s. 4 9 . 14 at lineal rate X .045 17. Amount of Line 14 taxable at sibling rate X.12 � . �� 17. � . �0 18. Amount of Line 14 taxable at collateral rate X.15 � . �� 18. � . �� 19. TAX DUE................................................................................................................ 19. 4 9. 14 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. � $ide 2 � 150561U243 15�561U243 � PDF created with pdfFactory Pro trial version www.pdffactory.com REV-1500 EX Page 3 File Number 21-13-1257 Decedent's Complete Address: DECEDENT'S NAME Knipe, Patricia A. STREET ADDRESS 297 Charles Rd. CITY STATE ZIP Mechanicsburg PA 17050 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 49.14 2. Credits/Payments A. Prior Payments B. Discount Total Credits(A +B) (2) 3. Interest (3) 0.63 4, if Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2,Line 20 to request a refund 5. If Line 1 +Line 3 is greater than line 2,enter the difference. This is the TAX DUE. (5) 49.77 Make Check Pa able to. REGIST ER OF WILLS, AGENT. ,�,,,,,.'�'��+w.�+.�#,�K. p�� '��fl,', s�.,.. � <.... .'�?t a° E��'�}xt �I[!iiyr I . .rq hd�`.�e.��,�� _x, >::x��. v a, ��.��e.. . . .. a, . p .:':., IRl PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred:............................................................................... ❑ � b. retain the right to designate who shall use the property transferred or its income:.................................. ❑ Ox c. retain a reversionary interest;or.............................................................................................................. d. receive the promise for life of either payments,benefits or care?............................................................ ❑ � 2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.................................................................................................................... ❑ ❑X 3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ ❑x 4. Did decedent own an individual retirement account,annuity,or other non-probate property which O ❑ containsa beneficiary designation?.................................................................................................................. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. �',3�`+ . . . _ . . .. '�;.�n�. . r,�4 n . _ . . ., ..» . „ zx For dates of death on or afler July 1,1994 and before Jan.1,1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after January t,1995,the tax rate imposed on the net value of transfers to or for the use of the suroiving spouse is 0 percent (72 P.S.§9116(a)(1.1)(ii)]. The statute does not exempt a transfer to a suroiving spouse from tax,and the statutory requirements for disclosure of assets and filing a tax retum are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The iax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent,an adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. . The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined, under Section 9102,as an individuai who has at least one parent in common with the decedent,whether by blood or adoption. PDF created with pdfFactory Pro trial version www.pdffactorv.com Rev-1503 EX+�08-12) SCHEDULE B � pennsylvania STOCKS � BONDS DEPARTMENT OF REVENUE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kni e, Patricia A. 21-13-1257 All propertyjointlyowned with right of survivorship must be disclosed on Schedule F. ITEM CUSIP VALUE AT DATE NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 36 shares of Metlife at$49/share discovered September, 1,764.00 2014 TOTAL(Also enter on Line 2,Recapitulation) 1,764.00 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.08-12) PDF created with pdfFactory Pro trial version www.pdffacto .ry com Rev1508 EX+�08-12) SCHEDULE E � pennsylvania CASH, BANK DEPOSITS, & MISC. Zti� DEPARTMENTOFREVENUE pERSONAL PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Kni e, Patricia A. 21-13-1257 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule P. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 Provider services refund 42.91 TOTAL(Also enter on Line 5,Recapitulation) 42.91 (If more space is needed,additional pages of the same size) Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.OS-12) PDF created with pdfFactory Pro trial version www.pdffactory.com REV-1511 EX+(OS-13) gCHEDULE H , pennsylvania DEPARTMENTOFREVENUE FUNERAL EXPENSES AND R SEDENTDEC o NT"R" � ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Knipe, Patricia A. 21-13-1257 DecedenYs debts must be reported on Schedule I. ITEM DESCRIPTION AMOUNT N MBER q, FUNERAL EXPENSES: B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Street Address City State Zio Year(s)Commission Paid 2. ,4ttorney's Fees Cunningham&Chernicoff, P.C. 500.00 3, Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) Claimant Street Address City State Zi� Relationshio of Claimant to Decedent 4. Probate Fees 30.00 5. AccountanYs Fees 6. Tax Return Preparer's Fees 185.00 7. Other Administrative Costs TOTAL(Also enter on line 9,Recapitulation) 715.00 Copyright(c)2013 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.08-13) PDF created with pdfFactory Pro trial version www.pdffactorv.com REV-1513 EX+(01-70) � pennsylvania SCHEDULE J DEPARTMENT OF REVENUE INHERITANCE TAX RETURN B E N E FI C IARI ES RESIDENT DECEDENT ' ESTATE OF FILE NUMBER Kni e, Patricia A. 21-13-1257 NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$) I� TAXABLE DISTRIBUTIONS [include outright spousal distributions,and transfers under Sec.9116 a 1.2 1 Erin Brown Grandchild 6.25%of 23 Stiles Drive Residuary Marysville,PA 17053 2 Kevin L Knipe Son 50%of 23 Stiles Drive Personalty and Marysville,PA 17053 40%of Residuary 3 Clinton Knipe Grandchild 6.25%of 23 Stiles Drive Residuary Marysville, PA 17053 4 Jack R.Knipe III Grandchild 6.25%of 1132 Rana Villa Ave. Residuary Camp Hill,PA 17011 5 Patricia L.Knipe Daughter-in-Law $500 967 W.Trindle Rd. Lot 25 Mechanicsburg, PA 17055 See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate. NON-TAXABLE DISTRIBUTIONS: II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10) PDF created with pdfFactory Pro trial version www.pdffactory.com SCHEDULE J BENEFICIARIES (Part I,Taxable Distributions) ESTATE OF: Patricia A. Knipe 10/30/2013 200-24-1665 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Ryan Knipe Grandchild 6.25%of Residuary 23 Stiles Drive Marysville,PA 17053 7 Kyra M. 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HhWrlol and aneM endyl4ry dav provWed by 8IX Flnanchl 6�lornqdon.p�aday da4 delPi�ed�K�8IX FNmalal Inlormalbn end�ubHq to bnn of uw. Y 0 szchanp�raqutremenb.edPlpow,b�y�p�tl��(eM)from�mv,lw�H 6 CompanY,Ma.�W Moro Inkrmadon on IHqBD�N d�pr�y�y�,��. . AQ tndaA rymboN�nd thsY cuvent Manald ehtu�. 9�ota va In bcal�Mehanp�tMr.R�d tdn „GW ry dah d�I�yW ib iNnuta Mr Npde9�and 40 minuts�Mr othsr axoh�nps�. 88P/DowJona�InAlea(8M1 from DowJono 6 Co�qnY�Ina 8��h1d�y�°b b p°�ad bY BIX Financlal Mformatbn ond b af k�q 80.mMuh�dehye0. All quota v�In rocol axhpnp�thns. 1 � CRYSTAL ST M , ` � � . o �. certifled public accountant � Patricia Knipe Invoice: 2031 c/o Bruce Warshawsky, Esq. Date: 12/22/2014 Harrisburg, PA 17110 Due Date: 01/21/2015 For professional service rendered as follows: �^� � �� v� �"----____,� Prepare 2014 US Form 1041 and PA Form 41 for additional income received for the sale of Met Life stock and related dividends. Electronic filing fees. Billed Time&Expenses $185.00 Invoice Total $185.00 ------------------------------------------------------------------------------------------• Please return this portion with payment. Invoice: 2031 Client ID: KNI1665 Date: 12/22/2014 Patricia Knipe Due Date: 01/21/2015 Amount Due: $185.00 Amount Enclosed: $ 212 S Sporting Hill Raad • Mechanicsburg, PA 17050 V:717.761.5080 • F: 717.761.508� www.my-cpa-firm.com